Provider Demographics
NPI:1831938836
Name:SULAK, ALEC MICHEAL (CRNA)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:MICHEAL
Last Name:SULAK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13084 TRAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3743
Mailing Address - Country:US
Mailing Address - Phone:713-471-8040
Mailing Address - Fax:
Practice Address - Street 1:13084 TRAIL HOLLOW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-3743
Practice Address - Country:US
Practice Address - Phone:713-471-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX900648163W00000X
TX1167846367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse